{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T15:36:44Z","timestamp":1767800204049,"version":"3.49.0"},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Background\/Objectives: Super-resolution deep-learning reconstruction (SR-DLR) is an advanced image reconstruction technique, but its effect on dynamic myocardial computed tomography perfusion (CTP) imaging has not been evaluated. This study aimed to examine the impact of SR-DLR on image quality and perfusion parameters in dynamic myocardial CTP. Methods: Thirty-five patients who underwent dynamic myocardial CTP for coronary artery disease assessment were retrospectively analyzed. Two CTP datasets were reconstructed using hybrid iterative reconstruction (HIR) and SR-DLR. Image quality was compared qualitatively and quantitatively, including image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and edge rise slope (ERS). Equivalence of CT-derived myocardial blood flow (CT-MBF) between two reconstructions was tested using a previously reported 15% equivalence margin. Intra-patient variability of CT-MBF was evaluated using the robust coefficient of variation (rCV). Results: In the qualitative assessment, SR-DLR had significantly higher scores in contrast (4.0 vs. 2.0) and sharpness (4.5 vs. 2.5) compared with HIR (p &lt; 0.001), while contrast scores were similar. In the quantitative assessment, SR-DLR demonstrated significantly lower image noise (19.4 vs. 29.4 HU), and improved SNR (6.1 vs. 4.1), CNR (13.7 vs. 10.9), and ERS (171.0 vs. 135.1 HU\/mm) (all p &lt; 0.001). Mean global CT-MBF was comparable (3.15 \u00b1 0.91 mL\/g\/min for HIR vs. 3.18 \u00b1 0.97 mL\/g\/min for SR-DLR) and equivalence was confirmed (p = 0.022). SR-DLR significantly reduced rCV compared with HIR (36.0% vs. 41.0%, p &lt; 0.001). Conclusions: SR-DLR enhances image quality in dynamic myocardial CTP while maintaining mean global CT-MBF and reducing intra-patient variability.<\/jats:p>","DOI":"10.3390\/tomography12010007","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:34:21Z","timestamp":1767789261000},"page":"7","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Super-Resolution Deep Learning Reconstruction Improves Image Quality of Dynamic Myocardial Computed Tomography Perfusion Imaging"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1047-9213","authenticated-orcid":false,"given":"Yusuke","family":"Kobayashi","sequence":"first","affiliation":[{"name":"Department of Radiology, Graduate School of Medicine, Ehime University, Toon 791-0295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6782-888X","authenticated-orcid":false,"given":"Yuki","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Radiology, Graduate School of Medicine, Ehime University, Toon 791-0295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoro","family":"Morikawa","sequence":"additional","affiliation":[{"name":"Department of Radiology, Graduate School of Medicine, Ehime University, Toon 791-0295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Radiology, Graduate School of Medicine, Ehime University, Toon 791-0295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1680-7799","authenticated-orcid":false,"given":"Kentaro","family":"Ohara","sequence":"additional","affiliation":[{"name":"Department of Radiology, Graduate School of Medicine, Ehime University, Toon 791-0295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9557-5189","authenticated-orcid":false,"given":"Takaaki","family":"Hosokawa","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ehime Prefectural Imabari Hospital, Imabari 794-0006, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Kouchi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Graduate School of Medicine, Ehime University, Toon 791-0295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3015-0168","authenticated-orcid":false,"given":"Shota","family":"Nakano","sequence":"additional","affiliation":[{"name":"Canon Medical Systems Corporation, Otawara 324-8550, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Pulmonology, Hypertension, and Nephrology, Graduate School of Medicine, Ehime University, Toon 791-0295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7645-4311","authenticated-orcid":false,"given":"Teruhito","family":"Kido","sequence":"additional","affiliation":[{"name":"Department of Radiology, Graduate School of Medicine, Ehime University, Toon 791-0295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1148\/radiol.14144050","article-title":"Myocardial CT Perfusion Imaging and SPECT for the Diagnosis of Coronary Artery Disease: A Head-to-Head Comparison from the CORE320 Multicenter Diagnostic Performance Study","volume":"274","author":"George","year":"2015","journal-title":"Radiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e002666","DOI":"10.1161\/CIRCIMAGING.114.002666","article-title":"Diagnostic accuracy of stress myocardial perfusion imaging compared to invasive coronary angiography with fractional flow reserve meta-analysis","volume":"8","author":"Takx","year":"2015","journal-title":"Circ. 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